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As of September 22, 2014, the NIDDK Clearinghouses Publication Catalog and Image
Library sites will be unavailable until further notice.
Although you will not be able to order publications, you can view, download, and
print them by using the links below.
For urgent matters, please send an email to catalog@niddk.nih.gov.

Insert J

Thiazolidinedione (THY-uh-ZOHL-ih-deen-DY-ohn)

Brand Name

Generic Name

__ Actos (AK-tohss)

__ pioglitazone (py-oh-GLIH-tuh-zohn)

__ Avandia (uh-VAN-dee-uh)

__ rosiglitazone (rohss-ih-GLIH-tuh-zohn)

If you are currently taking the thiazolidinedione medicine pioglitazone
(Actos) or a combination diabetes pill containing pioglitazone: See the
U.S. Food and Drug Administration (FDA) announcement on the
next page about this pill.

See Insert K for more information about combination diabetes pills
that contain pioglitazone or rosiglitazone.

In June 2011, the FDA warned that use of Actos for more than
1 year may be associated with an increased risk of bladder cancer.
The FDA recommended that people receiving treatment for bladder
cancer should not take Actos, and Actos should be used with caution
in people with a history of bladder cancer. This warning also
applies to the combination diabetes pills containing pioglitazone—Actoplus Met, Actoplus Met XR, and Duetact; see Insert K.

What does this type of pill do?

This type of pill helps treat insulin resistance. With insulin resistance,
your body doesn’t use insulin the way it should. Thiazolidinediones
help your insulin work properly. Then your blood glucose levels stay on
target and your cells get the energy they need.

Who should not take this type of pill?

People with heart failure, also called congestive heart failure, should not take this type of pill.

This type of pill can cause heart failure or make it worse.

Heart failure is a condition in which your heart no longer pumps properly. Then your body keeps too much fluid in your legs, ankles, and lungs.

Call your doctor right away if you have signs of heart failure. Warning signs include

having swelling in your legs or ankles

gaining a lot of weight in a short time

having trouble breathing

having a cough

being very tired

People being treated for bladder cancer should not take Actos or
combination pills containing pioglitazone.

If you have a history of bladder cancer and are taking Actos, talk with
your doctor.

You should also talk with your doctor about whether to take this type of pill if

you are pregnant, planning to get pregnant, or breastfeeding

you have liver disease

What are the possible side effects?

Heart failure is a serious side effect.

Bladder cancer may be more likely to occur in people who take Actos
for more than 1 year. Call your doctor right away if you have symptoms
of bladder cancer while taking Actos:

pink, red, or cola-colored urine, indicating the presence of blood

an urgent need to urinate or pain while urinating

pain in your back or lower abdomen

This type of pill doesn't cause low blood glucose by itself. But your risk of having low blood glucose goes up if you also take

diabetes pills that cause low blood glucose

insulin

Your doctor may ask you to take a lower dose of your other diabetes medicines while you take this type of pill.

Other possible side effects are

anemia (uh-NEE-mee-uh), a condition that can make you feel very tired

an increased risk of getting pregnant even if you're taking birth control pills

Women who take Actos, Avandia, or combination diabetes pills containing pioglitazone or rosiglitazone may have an increased risk of bone fractures.

If you take Actos or Avandia, your health care provider should make sure your liver is working properly. Call your doctor right away if you have any signs of liver disease: nausea, vomiting, stomach pain, tiredness, dark-colored urine, or loss of appetite.